Provider Demographics
NPI:1578118709
Name:BAILEY, SARAH JASMINE
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JASMINE
Last Name:BAILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1599 S NOVATO BLVD APT 204
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94947-4106
Mailing Address - Country:US
Mailing Address - Phone:925-818-6124
Mailing Address - Fax:
Practice Address - Street 1:1385 N HAMILTON PKWY
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94949-8276
Practice Address - Country:US
Practice Address - Phone:415-382-3363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor